Effects of sevoflurane increments on left ventricular systolic long-axis performance during sevoflurane–remifentanil anesthesia for cardiovascular surgery

Background The direct impact of sevoflurane on intraoperative left ventricular (LV) systolic performance during cardiac surgery has not been fully elucidated. Peak systolic tissue Doppler velocities of the lateral mitral annulus ( S ′) have been used to evaluate LV systolic long-axis performance. We...

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Bibliographic Details
Published in:Journal of anesthesia 2016-04, Vol.30 (2), p.223-231
Main Authors: Kwon, Won-Kyoung, Sung, Tae-Yun, Yu, Ga-Yon, Sidik, Hanafi, Kang, Woon-Seok, Lee, Younsuk, Kim, Tae-Yop
Format: Article
Language:English
Subjects:
Adult
Aged
Anesthesia - methods
Anesthesiology
Cardiac Surgical Procedures - methods
Critical Care Medicine
Dosage and administration
Drug therapy, Combination
Echocardiography, Doppler
Emergency Medicine
Female
Health aspects
Heart Ventricles
Humans
Intensive
Male
Medicine
Medicine & Public Health
Methyl Ethers - administration & dosage
Middle Aged
Mitral Valve - diagnostic imaging
Original Article
Pain Medicine
Piperidines - administration & dosage
Prospective Studies
Remifentanil
Sevoflurane
Systole
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Summary:Background The direct impact of sevoflurane on intraoperative left ventricular (LV) systolic performance during cardiac surgery has not been fully elucidated. Peak systolic tissue Doppler velocities of the lateral mitral annulus ( S ′) have been used to evaluate LV systolic long-axis performance. We hypothesized that incremental sevoflurane concentration (1.0–3.0 inspired-vol%) would dose-dependently reduce S′ in patients undergoing cardiac surgery due to mitral or aortic insufficiency. Methods In 20 patients undergoing cardiac surgery in sevoflurane–remifentanil anesthesia, we analyzed intraoperative S′ values which were determined after 10 min exposure to sevoflurane at 1.0, 2.0, and 3.0 inspired-vol% (T1, T2, and T3, respectively) with a fixed remifentanil dose (1.0 μg/kg/min) using transesophageal echocardiography. Results Linear mixed-effect modeling demonstrated dose-dependent declines in S′ according to the end-tidal sevoflurane concentration increments (C ET-sevoflurane , p  
ISSN:0913-8668
1438-8359
DOI:10.1007/s00540-015-2094-9